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Sleep Walking


What is Sleepwalking (Somnambulism)?

Sleepwalking (Somnambulism) is a series of complex behaviors that are initiated during slow wave sleep and result in walking during sleep.

What are the symptoms of Sleepwalking (Somnambulism)?

Ambulation (walking or moving about) that occurs during sleep. The onset typically occurs in prepubertal children.

Associated features include:

* difficulty in arousing the patient during an episode
* amnesia following an episode
* episodes typically occur in the first third of the sleep episode
* polysomnographic monitoring demonstrates the onset of an episode during stage 3 or 4 sleep
* other medical and psychiatric disorders can be present but do not account for the symptom
* the ambulation is not due to other sleep disorders such as REM sleep behavior disorder or sleep terror
* Somniloquy or sleeptalking may take place at the same time
* Incomprehensible mutterings are usually the case
* The range of the episodes can be as simple as just sitting up in bed, or walking about the room to episodes where the child runs and screams.
* In some sleepwalking cases, the child may urinate in an innappropriate place
* the child may use obscene words that would not be used when awake
* the child may fall and injure themselves

How serious is Sleepwalking?
For some, the episodes of sleepwalking occur less than once per month and do not result in harm to the patient or others. Others experince episodes more than once per month, but not nightly, and do not result in harm to the patient or others. In its most severe form, the episodes occur almost nightly or are associated with physical injury. If the sleepwalker exits the house, or is having frequent episodes and injuries are occurring -- seek professional help from a sleep disorder center in your area.

The child may feel embarrassment, shame, guilt, anxiety and confusion when they are told about their sleepwalking behavior. It is important to handle the child's feelings about sleepwalking with care.

How Common is Sleepwalking?
Medical reports show that about 18% of the population are prone to sleepwalking. It is more common in children than in adolescents and adults. Boys are more likely to sleepwalk than girls. The highest prevelance of sleepwalking was 16.7% at age 11 to 12 years of age. Sleepwalking can have a genetic tendency.

Sleepwalking Facts
Sleepwalking that starts at an early age, generally disappears as the child gets older. If the child outgrows the sleepwalking the age that it ended was approximately 13.8 years old. If the child begins to sleepwalk at the age of 9 or older, it often lasts into adulthood.

What can be done about Sleepwalking?
The majority of children who experience sleepwalking only have a mild display and frequency of the disorder. Therefore, most parents are relieved to know that most children will outgrow sleepwalking with time.

For more severe forms of sleepwalking, the late Dr. Nino-Murcia suggests:

* Improving the patterns of sleep-wake cycle thus eliminating the possible role of sleep deprivation as a trigger to sleepwalking. (Bedtime should be the same every night, taking care to get plenty of sleep).

* A full bladder may trigger an episode, so fluids should be restricted before bedtime.

* Parents should remove anything from the bedroom that could be hazardous or harmful to a child.

* The child's bedroom should be on the ground floor of the house. The possibility of the patient opening windows or doors should be eliminated.

* An assessment of the child should include a careful review of the current medication so that modifications can be made if necessary.

* Hypnosis has been found to be helpful for both children and adults.

* An accurate psychiatric evaluation could help to decide the need for psychiatric intervention.

* Benzodiazepines have been proven to be useful in the treatment of this disorder. A small dose of diazepam or lorazepam eliminates the episodes or considerably reduces them.

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